Evaluation of severe rhabdomyolysis on day 30 mortality in trauma patients admitted to intensive care: a propensity score analysis of the Traumabase registry
Authors' conclusion
Severe RM was not associated with 30-day mortality considering the overall cohort. However, it was associated with a 4.0% increase in 30-day mortality among patients with concurrent hemorrhagic shock.
Study context
- Population
- Trauma patients admitted to a major trauma centre and hospitalised in intensive care unit (ICU) with CK measurement, France, January 1, 2012 to July 1, 2023
- Participants
- 8,592 patients
- Exposure
- Severe rhabdomyolysis (RM) vs no severe RM
- Severe RMn = 1,544
- Outcome
- Mortality (effect of severe RM, ATT as risk difference)
- Follow-up
- 30 days
Methodological detailspropensity score analysis, doubly robust approach with inverse treatment weighting, national major trauma registry (Traumabase), sensitivity analyses
- Propensity score analysis
- Doubly robust approach with inverse treatment weighting
- National major trauma registry (Traumabase)
- Sensitivity analyses
Main finding
As reported in the abstract
30-day mortality, overall cohort
Average treatment effect on the treated (ATT) of severe RM, risk difference
0.073
−0.054 to 0.200
Observational data: associations, not effects.
Further findings
30-day mortality, HS subgroup (subgroup)
- ATT of severe RM, risk difference (1311 patients in HS subgroup)
- 0.039 [0.014 to 0.063]
30-day mortality, TBI subgroup (subgroup)
- No effect of severe RM on mortality in TBI subgroup
Mortality due to multiorgan failure or septic shock
- Mortality due to multiorgan failure, severe RM vs no severe RM
- 39.9% vs 12.4%
- Mortality due to septic shock, severe RM vs no severe RM
- 2.6% vs 0.8%
Safety
- Severe RM associated with greater trauma severity and more complications (renal or not) during ICU stay
Original publication
Evaluation of severe rhabdomyolysis on day 30 mortality in trauma patients admitted to intensive care: a propensity score analysis of the Traumabase registry. Crit Care. Published 22 November 2024. doi:10.
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